Provider Demographics
NPI:1316492580
Name:WEBB, DAVID (ATC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:WEBB
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 BRUSHY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-4007
Mailing Address - Country:US
Mailing Address - Phone:864-355-2895
Mailing Address - Fax:864-355-2992
Practice Address - Street 1:1300 BRUSHY CREEK RD
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-4007
Practice Address - Country:US
Practice Address - Phone:864-355-2895
Practice Address - Fax:864-355-2992
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9462255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer